Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003148552 |
---|---|
Provider Name | Mrs. Jennifer B Bettencourt-Navarro |
First Address | Bellflower, CA 90706-3101 |
Second Address | Santa Ana, CA 92706-2663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2010 |
Last Update Date | 09/02/2010 |